Officially the death toll stands at 43 with 35 people killed on Abaco and eight on Grand Bahama island. But there’s little doubt that death toll will increase as hundreds, and perhaps even thousands, remain missing. “We acknowledge that there are many missing and that the number of deaths is expected to significantly increase,” Prime Minister Hubert Minnis said. “This is one of the stark realities we are facing in this hour of darkness.” One witness who was on Abaco when Dorian struck said “it was like an atomic bomb went off.” The medical chief of staff at a hospital in Nassau said they would need facilities to hold the “staggering” number of bodies they expect to be found. And the health minister warned that the public should get ready for “unimaginable information about the death toll and the human suffering.”

Aid groups are rushing assistance to the islands as thousands are fleeing from Abaco to the capital of Nassau and even Florida. Thousands of people are still living in government or church facilities. “The needs remain enormous,” World Food Program spokesman Herve Verhoosel said. “Evacuations are slowly taking place by ferry, as hundreds of residents reportedly flee daily.”

The sheer destruction though is impeding search and rescue efforts as crews can’t bulldoze their way through debris amid fear there may be dead bodies. “We have been through this before, but not at this level of devastation,” Marvin Dames, the security minister in the Bahamas, said. At least 70,000 people are estimated to have been left homeless on Abaco and Grand Bahama.